| 摘要: | 傳統醫學提出桂枝湯具有「解肌」、「解表」的作用，認為對於表證時的肌肉痠痛不適具有治療的效果。而以現代醫學而言，造成肌肉痠痛不適，是因其「發炎」所致。因此本研究目的在於利用離心運動造成延遲性肌肉痠痛及肌肉發炎，再提供不同的桂枝湯治療方式，以探討其療效之間的關係。方法是以中國文化大學31名一般大專健康男性為研究對象，年齡為20.8±1.5歲，身高173.7±4.4公分，體重67.6±7.1公斤，肌肉重54±5公斤。採雙盲設計，將受試者隨機分配為以下四組：桂枝湯組（A1）、先補充桂枝湯後安慰劑組（A2）、先補充安慰劑後桂枝湯組（B1）、安慰劑組（B2）。觀察之生理性評估包括：最大肌力測量（MVC）、關節活動範圍（ROM）、手臂圍（CIR）、痠痛自覺量表（SOR）；血液分析包括：肝功能指標天門冬氨酸轉胺酵素（AST）、丙氨酸轉胺酵素（ALT）、肌肉損傷指標肌酸激酶（CK）、肌酸激酶-心肌型（CK-MB）、乳酸脫氫酶（LDH）；腎功能指標尿酸（UA）、血中尿素氮（BUN）、肌酸酐（Cr）。共測量、分析運動前及運動後5天。統計方法是以獨立樣本單因子單變量共變數分析各組對血液分析及生理性評估之影響效用是否有顯著差異。結果顯示，生理性評估部分四組MVC均無顯著差異，A1、A2預防組之ROM在離心運動後第2天與B2控制組達顯著，第3天B1治療組達顯著。在CIR、SOR於運動後第2至5天有補充桂枝湯都明顯低於控制組。血液分析部分ALT於運動後第1至4天預防組及治療組都低於控制組且達顯著差異。AST只有在運動後第1天A1組低於B1及B2組達顯著差異。CK於運動後第3至4天B1組低於A2、B2組達顯著差異。CK-MB於運動後第1天A1組低於與B1組且達顯著差異。LDH四組皆未達顯著差異。在BUN、Cr、UA部分，實驗結果均在正常範圍內。結論：離心運動所誘發的延遲性肌肉痠痛，在運動前預防或運動後治療補充桂枝湯，生理性評估及血液分析都有良好的效果，建議可藉由補充桂枝湯，以減緩運動後所造成肌肉損傷，因發炎反應而引起肌肉痠痛的不適感。
Purpose: Skeletal muscle soreness in early stages of infectious diseases in Chinese medicine is caused by inflammatory reactions. Gui-Zhi-Tang, a Chinese medical formula, is used to treat this infection. Delayed onset muscle soreness have induced muscle soreness and inflammation using eccentric exercise protocols. Methods: We investigated the effects of gui zhi tang (A1), pre-gui zhi tang post-placebo (A2), pre- placebo post- gui zhi tang (B1) and placebo (B2) on the prevention and treatment of delayed onset muscle soreness (DOMS). Thirty-one healthy male in Chinese Culture University (Age: 20.8±1.5 yr, Height: 173.7±4.4 cm, Weight: 67.6±7.1 kg, Muscle mass: 54±5 kg ) were randomized double-blind to one of four groups. Preexercise 2days and postexercise 5days measures were recorded physiological assessment for maximum isometric muscle strength (MVC), range of motion (ROM), circumference (CIR), muscle soreness (SOR); blood analysis for creatine kinase (CK), creatine kinase-MB (CK-MB), lactic dehydrogenase (LDH), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), uric acid (UA), blood urea nitrogen (BUN), creatinine (Cr). Data were analyzed by using One Way ANCOVA Analysis was conducted on the compiled data to compare the effects and interrelations among the groups. Results: The MVC with no significant differences between four groups. After eccentric exercise post-2days of A1 and A2 groups ROM was significantly higher than B2, post-3days of B1 was significantly higher than B2 (p＜.05). The CIR and SOR on post-2-5days A1、A2 and B1 was significantly lower than B2 (p＜.05). The ALT on post-1-4days A1、A2 and B1 was significantly lower than B2 (p＜.05). The A1 of AST was significantly lower than B1、B2 on post-1days (p＜.05). The CK on post-3-4days B1 was significantly lower than A2、B2 (p＜.05). The CK-MB on post-1days A1 was significantly lower than B1 (p＜.05). The LDH with no significant differences between four groups. The BUN、Cr、UA part of the experimental results were within the normal range. Conclusion: The present study demonstrates for the before exercise to prevent or treat post-exercise that supplement gui zhi tang exhibits physiological assessment and blood analysis has a good effects against eccentric exercise-induced skeletal muscle damage. |
